The warranties following will be made part of any policy issued under this program.
Warranted: The company named on the front hereof and as signed below does not engage in any of the following activities:
A. Manufacture of any product.
B. Re-Manufacture or re-building of any item (repairs allowed – see below).
C. Provide home health nursing, therapy or other medical or quasi-medical services of any kind.
D. Charge a fee for medically related services.
E. Sell or rent significant volumes of imported product (significant is deemed to be in excess of 5%).
F. Directly import any product.
Warranted: The company named on the front hereof and as named below will adhere to the following quality criteria to be eligible for (and remain eligible for) coverage under this insurance program:
A. Repair work allowed on owned or rented equipment only, by trained personnel and following manufacturers’ recommendations. No significant outside repair work is allowed.
B. The insured provides no express or implied warranties of merchantability, fitness for use, or safety other than those warranties insured is expressly authorized to provide as an agent on behalf of the manufacturer, by the manufacturer.
C. If oxygen is offered a true 24-hour service, program must exist.
D. Insured must have and designate a “Safety Manager” to receive, catalog and disseminate all safety and loss control information.
E. No injections or I.V. administration may be done by an insured unless the individual so doing is properly licensed and the administration is incidental to the sale or rental of the equipment and not on a fee basis.
F. Permanent installation of equipment must be disclosed and specifically approved by Insurer.
G. Customer agrees to no leasing or rental of equipment in off premises retail locations (malls, large retailer, hotels, resorts, casinos, etc.) without direct involvement of employed or subcontracted staff at the delivery point.
Warning!! This is an important document, which could affect your legal rights. Please read it again carefully and be certain it is correct and complete. Your signature below is your warranty to us that we can rely on this form. We have made no investigation of our own and the coverage decision will be based on this information. COVERAGE IS NOT BOUND OR STARTED BY THIS FORM. WE MAKE NO PROMISE TO INSURE. THIS IS ONLY A REQUEST FOR A QUOTE. YOU ARE NOT COVERED UNTIL AND UNLESS YOU RECEIVE A BINDER SO STATING.
The coverages that we are quoting from information on this form are Product/Completed Operations and Professional and/or General Liability Insurance. We base important decisions on your answers to these questions. We rely on the accuracy of your answers. If you have any questions about the form or your answers please ask your sales representative.
The questions in this application are not intended to, nor do they, indicate the existence, non-existence or limitations on any items of coverage. This document does not in any fashion determine the coverage provided.